原发性3级高血压患者黄斑区脉络膜厚度分析

doi:10.11958/20220487

摘要/Abstract

摘要：

目的观察原发性3级高血压患者脉络膜厚度变化特征,分析其相关影响因素。方法选取原发性3级高血压患者28例56眼为高血压组，健康志愿者29例正常眼底58眼作为正常组。应用光相干断层扫描增强深部成像对2组黄斑区脉络膜厚度进行测量，观察2组黄斑不同分区脉络膜厚度，比较2组黄斑各区视网膜厚度，分析高血压患者脉络膜厚度与视网膜厚度、病程的相关性。采用简单线性回归分析年龄对脉络膜厚度的影响。结果 2组N6区脉络膜厚度均显著低于其他区域（P<0.05）；高血压组中心区、S3、T3、I3、S6、T6、I6区脉络膜厚度显著低于正常组（P<0.05）。与正常组比较，高血压组I6和N6区视网膜厚度降低（P<0.05）。高血压组S3和S6区脉络膜厚度与视网膜厚度呈正相关（P<0.05）；高血压病程与黄斑各区脉络膜厚度均无相关性（P>0.05）；高血压组年龄与N3区脉络膜厚度无相关性（P>0.05），与中心区、S3、I6、N6区脉络膜相关性较弱（调整后R²<0.100，P<0.05），与T3、I3、S6、T6区脉络膜厚度均呈负相关（调整后R²分别为0.118、0.114、0.102和0.155，P<0.05）。结论原发性3级高血压患者的黄斑区脉络膜厚度低于正常人群，其脉络膜厚度变化与视网膜厚度和年龄改变具有一定相关性，与病程无相关性。

关键词: 高血压, 脉络膜, 高血压性视网膜病变, 视网膜, 光相干断层扫描增强深部成像

Abstract:

Objective To observe changes of choroidal thickness in patients with primary grade 3 hypertension and analyze its related influencing factors. Methods Twenty eight patients (56 eyes) with primary grade 3 hypertension were selected as the hypertension group, and 29 healthy volunteers (58 eyes) with normal fundus were selected as the normal group. The choroidal thickness in macular region was measured by optical coherence tomography enhanced deep imaging in patients of the two groups. The choroidal thickness in different macular regions was observed in the two groups, and the retinal thickness in each macular region of the two groups was compared. The correlation between choroidal thickness and retinal thickness and course of disease in patients with hypertension was analyzed. Simple linear regression was used to analyze the effect of age on choroidal thickness. Results The choroidal thickness in N6 zone of macula was significantly lower than that in other areas in two groups (P<0.05). The choroidal thickness in central area, S3, T3, I3, S6, T6 and I6 was significantly lower in the hypertensive group than that in the normal group (P<0.05). Compared with the normal group, the retinal thickness in I6 and N6 area was decreased in the hypertensive group (P<0.05). There was a positive correlation between choroidal thickness and retinal thickness in S3 and S6 zones of the hypertension group (P<0.05). There was no correlation between the duration of hypertension and the thickness of choroid in each area of macula (P>0.05). There was no correlation between patient age and thickness of choroid in N3 zone in the hypertension group (P>0.05), but there was weak correlation with the thickness of choroid in central, S3, I6 and N6 zone (adjusted R²<0.100, P<0.05). It was negatively correlated with thickness of choroid in the T3, I3, S6 and T6 zones (adjusted R²: 0.118, 0.114, 0.102 and 0.155, P<0.05). Conclusion The thickness of choroid in macular area is lower in patients with primary grade 3 hypertension than that in normal population. Changes of choroid thickness is correlated with retinal thickness and age, and no correlation with disease duration.

Key words: hypertension, choroid, hypertensive retinopathy, retina, EDI-OCT

中图分类号:

R774.1

图/表 6

参考文献 21

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组别	n	眼压（mmHg）	等效球径（D）	眼轴（mm）
正常组	58	15.55±1.97	-1.06±0.72	23.37±0.63
高血压组	56	15.64±2.09	-1.08±0.74	23.41±0.90
t		0.169	0.140	0.279

组别	n	眼压（mmHg）	等效球径（D）	眼轴（mm）
正常组	58	15.55±1.97	-1.06±0.72	23.37±0.63
高血压组	56	15.64±2.09	-1.08±0.74	23.41±0.90
t		0.169	0.140	0.279

组别	n		中心区		S3		T3	I3		N3
正常组	58		217.03±44.07		210.24±45.96		214.38±44.02	202.76±49.83		174.16±48.61^abcd
高血压组	56		189.80±48.53		191.23±50.90		184.96±42.83	181.64±46.68		165.50±53.05^abc
t			3.138^＊＊		2.094^＊		3.614^＊＊	2.333^＊		0.909
组别		S6		T6		I6			N6		F
正常组		205.19±47.28^e		197.19±42.19^e		187.79±42.08^a			144.22±37.05^abcdefgh		15.686^＊＊
高血压组		186.75±47.18^e		181.14±39.51		170.88±42.88			132.66±43.66^abcdefgh		8.783^＊＊
t		2.084^＊		2.094^＊		2.126^＊			1.527

组别	n		中心区		S3		T3	I3		N3
正常组	58		217.03±44.07		210.24±45.96		214.38±44.02	202.76±49.83		174.16±48.61^abcd
高血压组	56		189.80±48.53		191.23±50.90		184.96±42.83	181.64±46.68		165.50±53.05^abc
t			3.138^＊＊		2.094^＊		3.614^＊＊	2.333^＊		0.909
组别		S6		T6		I6			N6		F
正常组		205.19±47.28^e		197.19±42.19^e		187.79±42.08^a			144.22±37.05^abcdefgh		15.686^＊＊
高血压组		186.75±47.18^e		181.14±39.51		170.88±42.88			132.66±43.66^abcdefgh		8.783^＊＊
t		2.084^＊		2.094^＊		2.126^＊			1.527

组别	n	中心区	S3	T3	I3	N3	S6	T6	I6	N6
正常组	58	259.33±16.55	335.60±21.56	322.43±20.05	332.87±16.20	336.21±17.29	307.71±20.15	287.66±20.66	299.60±12.64	317.27±13.22
高血压组	56	254.52±19.64	333.45±14.94	320.64±15.86	327.95±14.17	333.89±13.50	203.63±16.31	285.20±18.11	292.79±12.76	306.84±14.68
t		1.415	0.619	0.527	1.728	0.795	1.186	0.675	2.865^＊＊	3.992^＊＊